Evidence map›Paper›PMID 40425886›Full record

ArticleAesthetic plastic surgery2025

Frontalis Only Contracts in One Direction: AI-Quantum Elasticity and Resistance Gradient Reveals True Nature of Forehead Muscle Movement.

Eqram Rahman, William Richard Webb, Parinitha Rao, Shabnam Sadeghi-Esfahlani, Nanze Yu, Patricia E Garcia, Sotirios Ioannidis, Karim Sayed, Wolfgang G Philipp-Dormston, Ada R T Almeida and 3 more

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Article in Aesthetic plastic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Eqram RahmanResearch and Innovation Hub, Innovation Aesthetics, London, UK. Eqram.rahman@gmail.com.ORCID 0000-0002-8443-8338
William Richard WebbResearch and Innovation Hub, Innovation Aesthetics, London, UK.
Parinitha RaoThe Skin Address, Aesthetic Dermatology Practice, Bangalore, India.
Shabnam Sadeghi-EsfahlaniMedical Technology Research Centre, Anglia Ruskin University, Chelmsford, Essex, UK.
Nanze YuDepartment of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China.
Patricia E GarciaPrivate practice in dermatology, Puerto Vallarta, Mexico.
Sotirios IoannidisPlastic Surgery Clinic, 546 21, Thessaloniki, Greece.
Karim SayedNomi Oslo, Oslo, Norway.
Wolfgang G Philipp-DormstonHautzentrum Koeln, Cologne, Germany.
Ada R T AlmeidaHospital Do Servidor Publico Municipal, Sao Paulo, Brazil.
Woffles T L WuWoffles Wu Aesthetic Surgery and Laser Centre 1, Orchard Boulevard Suite 09-02, Singapore, Singapore.
Greg J GoodmanMonash University Australia, Clayton, VIC, Australia.
Jean D A CarruthersDepartment of Ophthalmology, University of British Columbia, Vancouver, BC, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe biomechanics of frontalis muscle contraction and its interaction with skin remain contentious, particularly the debated bidirectional movement theory. This study introduces the quantum elasticity and resistance gradient (QERG) model to explain observed skin dynamics during frontalis contraction using elastic resistance principles.

methodsAn AI-driven biomechanical model incorporating deep learning frameworks (TensorFlow, PyTorch) was developed to simulate skin deformation and muscle forces during frontalis contraction. The model was trained using 3D facial scans from a diverse cohort of 600 subjects, representing various ethnicities, genders, and ages. Resistance gradients and wrinkle formation were calculated using finite element analysis, and machine learning (random forest, deep neural networks) was employed to predict skin behaviour.

resultsCranial displacement averaged 6.9 mm across all subjects, with younger individuals (18-30 years) showing higher displacement than older individuals (50-65 years). Ethnic differences in displacement and wrinkle formation were observed, with Caucasians exhibiting greater displacement (7.3 mm) compared to African Americans and Asians (6.0 mm and 5.8 mm). The QERG model predicted skin folding at an average threshold of 41.2 mm above the eyebrows, with variations linked to ethnicity, age, and gender. AI models achieved high accuracy (R

conclusionThe QERG model confirms that frontalis muscle contraction is unidirectional, with skin folding attributed to elastic resistance rather than opposing forces. These findings challenge previous theories of bidirectional contraction and have implications for aesthetic treatments. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Indexed as

Facial MusclesForeheadMuscle ContractionSkin AgingAdolescentAdultAgedBiomechanical PhenomenaCohort StudiesElasticityFemaleHumansImaging, Three-DimensionalMaleMiddle AgedYoung AdultAI simulationsElastic resistanceFrontalis muscleQERG modelSkin foldingWrinkle formation

Identifiers

PMID40425886

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.